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General NPI Number Information
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NPI Number | 1659236586
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Entity Type | Individual
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Provider Name | TIFFANY KIRK KIRK RN
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Gender | Female
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 5929 E STATE HIGHWAY 18
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-7429
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Country | US
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Telephone | 870-409-5702
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Fax | 870-762-0789
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Provider Business Mailing Address
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Address Line | 5929 E STATE HIGHWAY 18
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-7429
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Country | US
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Telephone | 870-409-5702
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Fax | 870-762-0789
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R099183
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License Number State | AR
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